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-`'`co? °- CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YWY) <br />04/25/2012 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ? <br />IMPORTANT: If the certifleate holder Is an ADDITIONAL INSURED, the polley(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and contlltlons of the Polley, certain polleles may require an elndoreement. A statement on this ceRiflcate does not confer rights to the <br />certlflcate holder In lieu of such endorsement(s). <br />PRODUCER CONTACT ,.,?_,_ ? ?,___ <br />DFI - D)Gerolamo Family Insurance Services <br />2027 Hamner Ave <br />Norco, CA 92860 <br />License #: OD26889 <br />INSURED INSURER B <br />PRESTIGE STRIPING SERVICES INC. INSURERC: <br />1054 Railroad St INSURER D: <br />Corona, CA 92882 INSURER E <br />11SVRER F <br />COVERAGES CERTIFICATE NUMBER: 00012074-X309320 REVISION Nl1MRFR• 9a9 <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION O ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ILTR TYPE OF INSURANCE A POLICY NUMBER ? MM/DDY/YYFYY MM%DD/YYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY <br />PR MI <br />S <br /> CLAIMS <br />MADE ? OCCUR <br /> - MED EXP (Any one rson $ <br /> PERSONAL 8 ADV INJURY S <br /> <br /> ' GENERAL AGGREGATE $ <br /> <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ <br /> POLICY PRO- LOC $ <br />A AUT OMOBILE LIABILITY Y N BAP173013 04/29/2012 04/29/2013 Ee eBoCaDt SINGLE LIMIT ,I OOO OOO <br /> X ANY AUTO BODILY INJURY (Per person) $ <br /> ALL OtMJED <br />AUTOS SCHEDULED <br />AUTOS BODILY INJURY Per aoodant <br />( ) $ <br /> <br />X <br />HIRED AUTOS X NON-0NR?IED <br />AUTOS PROPERTY DAMAGE <br />Per aCCideM $ <br /> <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS IJAB CLAIMS-MADE AGGREGATE $ <br /> <br /> DED RETENTION $ $ <br /> WORKERS COMPENSATON <br />KC STATU- OTH- <br /> AND EMPLOYERS' LIABILITY <br /> Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDEDi ? <br /> <br />N / A <br /> <br />G.L. EACH ACCIDENT <br /> <br />$ <br /> (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ <br /> IT yes, dasbiba under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$ <br /> <br />DESCRIPTON OF OPERATONS / LOCATONS /VEHICLES (Attach ACORD 101, AddWOnal Ranvrka SebeauM, M more space Is raqulrad) <br />10 DAYS NOTICE WILL BE SENT FOR NON PAYMENT OF PREMIUM. <br />CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED. <br />JOB: VARIOUS JOB LOCATIONS <br />CERTIFICATE HOLDER cANCFI 1 ATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ATTN• ROCK GARCIA ACCORDANCE WITH THE POLICY PROVISIONS. <br />305 E <br />4TH STREET <br />SUITE 201 <br />. <br />, <br />SANTA ANA, CA 92701 AUTHOR D REPRESENTATIVE <br /> a <br /> CES <br />V???"F©TgBg`?15'rd1fC'IORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />PrinteU by CES on April 25, 20'12 aY '12:'16PM